Skip to main content
Erschienen in: European Spine Journal 8/2012

01.08.2012 | Original Article

Efficacy of multilevel anterior cervical discectomy and fusion versus corpectomy and fusion for multilevel cervical spondylotic myelopathy: a minimum 5-year follow-up study

verfasst von: Kyung-Jin Song, Kwang-Bok Lee, Ji-Hoon Song

Erschienen in: European Spine Journal | Ausgabe 8/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We evaluated radiologic and clinical outcomes to compare the efficacy of anterior cervical discectomy and fusion (ACDF) and anterior corpectomy and fusion (ACCF) for multilevel cervical spondylotic myelopathy (CSM).

Methods

A total of 40 patients who underwent ACDF or ACCF for multilevel CSM were divided into two groups. Group A (n = 25) underwent ACDF and group B (n = 15) ACCF. Clinical outcomes (JOA and VAS scores), perioperative parameters (length of hospital stay, blood loss, operation time), radiological parameters (fusion rate, segmental height, cervical lordosis), and complications were compared.

Results

Both group A and group B demonstrated significant increases in JOA scores and significant decreases in VAS. Patients who underwent ACDF experienced significantly shorter hospital stays (p = 0.031), less blood loss (p = 0.001), and shorter operation times (p = 0.024). Both groups showed significant increases in postoperative cervical lordosis and achieved satisfactory fusion rates (88.0 and 93.3 %, respectively). There were no significant differences in the incidence of complications among the groups.

Conclusions

Both ACDF and ACCF provide satisfactory clinical outcomes and fusion rates for multilevel CSM. However, multilevel ACDF is associated with better radiologic parameters, shorter hospital stays, less blood loss, and shorter operative times.
Literatur
1.
Zurück zum Zitat Oh MC, Zhang HY, Park JY et al (2009) Two-level anterior cervical discectomy versus one-level corpectomy in cervical spondylotic myelopathy. Spine 34:692–696PubMedCrossRef Oh MC, Zhang HY, Park JY et al (2009) Two-level anterior cervical discectomy versus one-level corpectomy in cervical spondylotic myelopathy. Spine 34:692–696PubMedCrossRef
2.
Zurück zum Zitat Rao RD, Gourab K, David KS (2006) Operative treatment of cervical spondylotic myelopathy. J Bone Surg Am 88:1619–1640PubMedCrossRef Rao RD, Gourab K, David KS (2006) Operative treatment of cervical spondylotic myelopathy. J Bone Surg Am 88:1619–1640PubMedCrossRef
3.
Zurück zum Zitat Lin Q, Zhou X, Wang X et al (2012) A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy. Eur Spine J 21(3):474–481PubMedCrossRef Lin Q, Zhou X, Wang X et al (2012) A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy. Eur Spine J 21(3):474–481PubMedCrossRef
4.
Zurück zum Zitat Gore DR (2001) The arthrodesis rate in multilevel anterior cervical fusions using autogenous fibula. Spine 26:1259–1263PubMedCrossRef Gore DR (2001) The arthrodesis rate in multilevel anterior cervical fusions using autogenous fibula. Spine 26:1259–1263PubMedCrossRef
5.
Zurück zum Zitat Hilibrand AS, Fye MA, Emery SE et al (2002) Increased rate of arthrodesis with strut grafting after multilevel anterior cervical decompression. Spine 27:146–151PubMedCrossRef Hilibrand AS, Fye MA, Emery SE et al (2002) Increased rate of arthrodesis with strut grafting after multilevel anterior cervical decompression. Spine 27:146–151PubMedCrossRef
6.
Zurück zum Zitat Hwang SL, Lee KS, Su YF et al (2007) Anterior corpectomy with iliac bone fusion or discectomy with interbody titanium cage fusion for multilevel cervical degenerated disc disease. J Spinal Disord 20:565–570CrossRef Hwang SL, Lee KS, Su YF et al (2007) Anterior corpectomy with iliac bone fusion or discectomy with interbody titanium cage fusion for multilevel cervical degenerated disc disease. J Spinal Disord 20:565–570CrossRef
7.
Zurück zum Zitat Iwasaki M, Kawaguchi Y, Kimura T et al (2002) Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: more than 10 years follow up. J Neurosurg 96:180–189PubMedCrossRef Iwasaki M, Kawaguchi Y, Kimura T et al (2002) Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: more than 10 years follow up. J Neurosurg 96:180–189PubMedCrossRef
8.
Zurück zum Zitat Ellison TS, Hartman MB, Brigham CD (1997) Fusion rates for two-level ACDF+ plating versus subtotal corpectomy and fusion. Presented at the annual meeting of the North American Spine Society, New York, October 25 Ellison TS, Hartman MB, Brigham CD (1997) Fusion rates for two-level ACDF+ plating versus subtotal corpectomy and fusion. Presented at the annual meeting of the North American Spine Society, New York, October 25
9.
Zurück zum Zitat Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 6:496–511 Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 6:496–511
10.
Zurück zum Zitat Matz PG, Pritchard PR, Hadley MN (2007) Anterior cervical approach for the treatment of cervical myelopathy. Neurosurgery 60:S64–S70PubMedCrossRef Matz PG, Pritchard PR, Hadley MN (2007) Anterior cervical approach for the treatment of cervical myelopathy. Neurosurgery 60:S64–S70PubMedCrossRef
11.
Zurück zum Zitat Orr RD, Zdeblick TA (1999) Cervical spondylotic myelopathy. Approaches to surgical treatment. Clin Orthop Relat Res 359:58–66PubMedCrossRef Orr RD, Zdeblick TA (1999) Cervical spondylotic myelopathy. Approaches to surgical treatment. Clin Orthop Relat Res 359:58–66PubMedCrossRef
12.
Zurück zum Zitat Hilibrand AS, Carlson GD, Palumbo MA et al (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 81:519–528PubMed Hilibrand AS, Carlson GD, Palumbo MA et al (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 81:519–528PubMed
13.
Zurück zum Zitat Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery. Spine 27:2453–2458PubMedCrossRef Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery. Spine 27:2453–2458PubMedCrossRef
14.
Zurück zum Zitat Wada E, Suzuki S, Kanazawa A et al (2001) Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy. A long-term follow up study over 10 years. Spine 26:1443–1447PubMedCrossRef Wada E, Suzuki S, Kanazawa A et al (2001) Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy. A long-term follow up study over 10 years. Spine 26:1443–1447PubMedCrossRef
15.
Zurück zum Zitat Wang JC, McDonough PW, Endow KK et al (2001) A comparison of fusion rates between single-level cervical corpectomy and two-level discectomy and fusion. J Spinal Disord 14:222–225PubMedCrossRef Wang JC, McDonough PW, Endow KK et al (2001) A comparison of fusion rates between single-level cervical corpectomy and two-level discectomy and fusion. J Spinal Disord 14:222–225PubMedCrossRef
16.
Zurück zum Zitat Papadopoulos EC, Huang RC, Girardi FP et al (2006) Three-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results. Spine 31:897–902PubMedCrossRef Papadopoulos EC, Huang RC, Girardi FP et al (2006) Three-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results. Spine 31:897–902PubMedCrossRef
17.
Zurück zum Zitat DePalma AF, Rothman RH, Lewinnek GE et al (1972) Anterior interbody fusion for severe cervical disc degeneration. Surg Gynecol Obstet 134:755–758PubMed DePalma AF, Rothman RH, Lewinnek GE et al (1972) Anterior interbody fusion for severe cervical disc degeneration. Surg Gynecol Obstet 134:755–758PubMed
18.
Zurück zum Zitat Sasso RC, Ruggiero RA Jr, Reilly TM et al (2003) Early reconstruction failures after multilevel cervical corpectomy. Spine 28:140–142PubMedCrossRef Sasso RC, Ruggiero RA Jr, Reilly TM et al (2003) Early reconstruction failures after multilevel cervical corpectomy. Spine 28:140–142PubMedCrossRef
19.
Zurück zum Zitat Ikenaga M, Shikata J, Tanaka C (2006) Long-term results over 10 years of anterior corpectomy and fusion for multilevel cervical myelopathy. Spine 31:1568–1574PubMedCrossRef Ikenaga M, Shikata J, Tanaka C (2006) Long-term results over 10 years of anterior corpectomy and fusion for multilevel cervical myelopathy. Spine 31:1568–1574PubMedCrossRef
20.
Zurück zum Zitat Vaccaro AR, Falatyn SP, Scuderi GJ et al (1998) Early failure of long segment anterior cervical plate fixation. J Spinal Disord 11:410–415PubMed Vaccaro AR, Falatyn SP, Scuderi GJ et al (1998) Early failure of long segment anterior cervical plate fixation. J Spinal Disord 11:410–415PubMed
Metadaten
Titel
Efficacy of multilevel anterior cervical discectomy and fusion versus corpectomy and fusion for multilevel cervical spondylotic myelopathy: a minimum 5-year follow-up study
verfasst von
Kyung-Jin Song
Kwang-Bok Lee
Ji-Hoon Song
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
European Spine Journal / Ausgabe 8/2012
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2296-x

Weitere Artikel der Ausgabe 8/2012

European Spine Journal 8/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Fehlerkultur in der Medizin – Offenheit zählt!

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.